Health care insurance planning is critical when getting out
Transition Assistance Program | .
published: November 30, 2012
Editor’s Note: We thought we’d put this on the Education page because everyone transitioning out of the military needs to be educated on this subject. It’s crucial for a smooth transition, so please take time to give it a read.
Many Service members are caught by surprise when they realize the actual cost of providing health care insurance for themselves and their families. Before you leave military service, you need to arrange for health insurance to protect you and your family. This article will help you learn about your options and plan for your health care insurance needs.
Most people leaving the military get civilian jobs that provide health care insurance. The result is continuous coverage. Sometimes, however, there is a gap between the time your service-provided coverage ends and your new employer's coverage begins. During this time, you alone are responsible for paying all the medical bills that you and your family might acquire. This could be devastating. A one-day stay in the hospital could cost thousands of dollars!
Fortunately, several resources are available to ensure continuous, comprehensive, quality health care for you and your family. Your options will be explained to you during your appointment at your Transition Office. For specific health insurance questions, call the Health Benefits Advisor at the nearest military medical treatment facility once you have returned home or contact Military One Source at http://www.militaryonesource.com for assistance. Avoid running up medical bills without having prior approval for payment.
Transitional Health Care for You and Your family
The Transitional Assistance Management Program (TAMP) offers transitional TRICARE coverage to certain separating members and their eligible family members. Care is available for 180 days.
There are four categories of eligibility for TAMP:
- Members involuntarily separated from active duty and their eligible family members;
- National Guard and Reserve members, collectively known as the Reserve Component (RC), separated from active duty after being called up or ordered in support of a contingency operation for an active duty period of more than 30 days and their family members
- Members separated from active duty after being involuntarily retained in support of a contingency operation and their family members; and
- Members separated from active duty following a voluntary agreement to stay on active duty for less than one year in support of a contingency mission and their family members.
You and your eligible family members who were previously enrolled in TRICARE Prime and desire to continue their enrollment upon the sponsor’s separation from active duty status are required to reenroll. To reenroll, the sponsor or family member must complete and submit a TRICARE Prime enrollment application. Contact your servicing personnel center prior to separating to see if you are TAMP eligible.
Under TAMP, former active duty sponsors, former activated reservists, and family members of both are not eligible to enroll or reenroll in TRICARE Prime Remote or in TRICARE Prime Remote for Active Duty Family Members because both programs require the sponsor to be on active duty. Under the TAMP, the sponsor is no longer on active duty and is treated as an active duty family member for benefits and cost sharing purposes.
Once your initial transitional health care ends you and your family are no longer eligible to use military treatment facilities or TRICARE. However, you may purchase health care coverage, known as the Continued Health Care Benefit Program (CHCBP). You must enroll in CHCBP within 60 days of losing your TRICARE eligibility to qualify for the benefits.
You and your family members will be issued over-stamped identification cards that will allow you to use military treatment facilities after your separation. The cards will be marked with the dates you are eligible for transitional health care.
You can learn more about TRICARE at http://www.tricare.mil/mybenefit/home/overview/SpecialPrograms/TAMP.
CHCBP: Your Option to Purchase Temporary Medical Coverage
Following the loss of eligibility to military medical benefits, you or a family member may apply for temporary, transitional medical coverage under the Continued Health Care Benefit Program (CHCBP). CHCBP is a premium-based health care program providing medical coverage to a select group of former military beneficiaries. CHCBP is similar to, but not part of, TRICARE. The CHCBP program extends health care coverage to the following individuals when they lose military benefits:
- The service member (who can also enroll his or her family members)
- Certain former spouses who have not remarried
- Certain children who lose military coverage
DoD contracted with Humana Military Healthcare Services, Inc. to administer CHCBP. You may contact Humana Military Healthcare Services, Inc., in writing or by phone for information regarding CHCBP. This includes your eligibility for enrolling in the program, to request a copy of the CHCBP enrollment application, to obtain information regarding the health care benefits that are available to CHCBP enrollees, and to obtain information regarding the premiums and out-of-pocket costs once you are enrolled.
For more information about CHCBP, visit the CHCBP Web site at http://www.humana-military.com/south/bene/TRICAREPrograms/chcbp.asp or call 1-800-444-5445. Contact your regional contractor or a Beneficiary Counseling and Assistance Coordinator (BCAC) (http://www.tricare.mil/bcacdcao/) to discuss your eligibility for this program.
Department of Veterans Affairs (VA) Medical Care
For most veterans, entry into the VA health care system begins by applying for enrollment. There are eight (8) Priority Groups, with Priority Group 1 being the highest and Priority Group 8 being the lowest. Once enrolled, veterans have access to VA’s comprehensive Medical Benefits Package and can receive health care at VA health care facilities anywhere in the country. Veterans are assigned to a Priority Group based on such factors as service-connected disability, household income, or special eligibility factors such as combat veteran status or recipient of the Purple Heart award and/or former Prisoner of War. Detailed information regarding Priority Groups is listed on the web at http://www.va.gov/healtheligibility/Library/pubs/EPG/.
Note: Effective January 17, 2003, VA is no longer enrolling new Priority Group 8 veterans.
VA Health Care Enrollment
Generally, you must be enrolled in the VA health care system to receive benefits offered in the Medical Benefits Package. To apply for VA health care benefits, including enrollment, simply fill out a 10-10EZ Application for Health Care Benefits. This Enrollment form and instructions can be found at: https://www.1010ez.med.va.gov/sec/vha/1010ez/ or you may apply at your local VA medical center or call the VA Health Benefits Call Center at 1 877-237-VETS (8387).
Returning Combat Veterans
Veterans, including Reserve and National Guard members, who served on active duty in a theater of combat operations during a period of war after the Gulf War or in combat against a hostile force after Nov. 11, 1998, are eligible for enrollment in Priority Group 6 unless otherwise eligible for enrollment in a higher Priority Group. For five years after discharge or release from active duty, these veterans receive cost-free health care services for conditions that may be related to their combat service but some may be required to pay co-pays for conditions not related to their service.
Special Note: If you served in the Gulf War, the VA has established a website http://www.publichealth.va.gov/exposures/ to provide information to you. You may also call the Gulf War/Agent Orange Hotline at 1-800-749-8387 press 3.
There is no requirement for returning combat veterans to provide household income information, however, agreement to pay applicable co-payments must be given if not otherwise eligible for cost-free care for conditions clearly unrelated to their combat service.
To take advantage of this enhanced enrollment authority, you must apply for VA health care benefits within five years of your discharge from active duty.
Additionally, it is important to note that Reserve and National Guard members may also qualify for VA health care benefits, even without service in the theater of combat operations, if they were activated for federal service, served the full period for which they were called or ordered to active duty, and received a discharge other than dishonorable. For more information on benefits for Reserve and National Guard members visit VA’s Seamless Transition web site for National Guard and Reserve Personnel at http://www.oefoif.va.gov/.
Note: Active duty for training alone is not qualifying service time for VA health care benefit purposes.
Go to http://www.va.gov/healtheligibility/ for more information.
Family Members and Survivors
VA, through the Civilian health and medical Program of the Department of Veterans Affairs (CHAMPVA), may provide medical care for the children and spouse of veterans who have a VA permanent and total service-connected disability rating, or those survivors of veterans who died as a result of a service-connected disability, or who died while on active duty. Spouses and children who are eligible for TRICARE/CHAMPUS are not eligible for CHAMPVA benefits. Information on CHAMPVA benefits may be found on the CHAMPVA website http://www.va.gov/hac/hacmain.asp or by calling 1-800-733-8387.
VA Provided Dental Care
VA may provide any treatment indicated as reasonably necessary for a one-time correction of dental conditions if you apply within 90 days after your separation/discharge. However, if the military provided a dental examination and treatment within 90 days prior to your separation you cannot receive care. This is annotated in Block 17 of your DD-214. VA also provides dental care to eligible veterans in other situations. For further information regarding eligibility for VA dental benefits go to: http://www.va.gov/DENTAL/index.asp.
Shortly after you are deactivated/demobilized: To receive one-time care through the VA you must have a documented dental examination at a DTF within 90 days of separation from active duty. You must also have uncompleted dental care and you must apply to the VA within 90 days after separation. You will not receive dental care if the military provided a dental examination and completed all dental treatment within 90 days prior to your release from active duty.
Post-Military Dental Care
Dental care is distinct from medical care. As a result, the types and amounts of coverage are different, as noted below.
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Before you separate: Early in your transition process, you and your family should have routine dental checkups. You should also ensure that your family members obtain necessary treatment under the TRICARE Family Member Dental Plan prior to your expiration of eligibility for the program. If problems are found early enough, work can be completed prior to separation, at little or no cost to you. Emergencies will also be taken care of until your separation.
Shortly after you separate: The VA provides one-time dental care for veterans if you apply within 90 days after separation. However, you will not receive dental care if the military provided a dental examination and treatment within 90 days prior to your separation.
Retirees: You should check with your local military dental facility regarding dental services.
TRICARE Retiree Dental Program.
The TRICARE Retiree Dental Program (TRDP) is offered by the Department of Defense (DoD) through the TRICARE Management Activity (TMA). The Federal Services division of Delta Dental Plan of California, located in Sacramento, California, administers and underwrites the TRDP for the TMA. The TRDP offers comprehensive, cost-effective dental coverage for uniformed services retirees and their eligible family members.
The TRDP will also make available a premium-based dental insurance program for military retirees, members of the Retired Reserve receiving a retired pay, un-remarried surviving spouses, and dependents. Eligible beneficiaries will pay the full cost of the dental insurance coverage. TRDP will feature a basic dental care and treatment, to include diagnostic services, preventative services, basic restoration services, endodontic, surgical services, and emergency services. Retiring members should explore this program, depending on their future employer's health benefits package.
Following separation: You will need to obtain dental insurance from your new employer or through a private insurer.
To learn more about your entitlement to dental care, contact your VA regional office. For more information regarding the Retiree Dental Program: consult the TRICARE website http://www.tricare.mil/ or call 1.800.866.8499.
— Source: Department of Defense Transition Assistance Program